Career Changer

Position after MHCDS
Medical Director (equivalent to Chief Medical Officer)

Shift in Career Trajectory
Departmental Administration to Operations and Strategy

Career-Changing Experience
Entered the Dartmouth program not being able to conceptualize health care reform. “The topic was so complex,” she recalls. “How could you identify the problem? How could someone start to solve it?” Changed from someone who viewed health care as treating illness to health care as promoting wellness.

Key Tools
Process-mapping — knowing exactly what happens as a patient moves through each part of the system. Small, rapid cycles of change. Leadership and engagement with the patient community.

New Career Challenge
Orchestrating Glen Cove Hospital’s controversial transformation from a traditional in-patient facility to one focused on ambulatory and outpatient needs.

Telling Details
1. “NS-LIJ’s regional CEO, Eugene Tangney, told me, ‘I’ve heard all about you, and I’m just going to stay out of your way.’” 2. “Headhunters have started calling me and saying, ‘Once you’re done with the transition there...’”

Partnering with the Community

Trained in emergency and internal medicine, Barbara Barnett was recently promoted to Medical Director (Chief Medical Officer) at Glen Cove Hospital, part of the North Shore Long Island Jewish Health System. The movement between jobs represented a movement in mindset: Barnett had spent years focusing on day-to-day, high-value patient care delivered in a hospital setting. After completing the MHCDS program, she began thinking of health in a much broader context, one that included preventative care and life choices outside of the hospital. (At Dartmouth, just to pick one example, she learned about the connection between good dental hygiene and general health.)

Three months into her new position, the hospital’s administration announced that Glen Clove would be de-emphasizing its traditional in-patient care, and transitioning to exclusively providing ambulatory and outpatient services.

Barnett’s training as a physician, her emergency department experience, and the leadership and change-management skills she acquired through the MHCDS program positioned her to take on this challenging — and transformative — role.

Initially “devastated” by the announcement, which promised to close down an important aspect of the work her career had been built on, Barnett quickly saw the opportunity in it, partly by recalling the frequent frustration she’d felt when expedience or lack of options led to admitting ER patients who really didn’t need to be admitted. She immediately focused her attention on the community of patients who depended on Glen Cove’s service. Her job, in essence: To find out what they need, and to work with them and the hospital’s staff and its partners to make sure that need is met in a way that is cost effective in the long run.

An illustration of the kind of “Box 3” thinking needed to pull this off: Recognizing the high percentage of elderly residents in the patient community, and knowing how many hospital admissions at Glen Cove are the result of older patients falling or getting injured, Barnett has created partnerships with area nursing homes and is establishing a 3-1-1 call service, whereby residents can call and arrange to have high school students come shovel a snowy walk, for instance, rather than try shoveling it themselves. The hospital will pick up the small cost of the shoveling — and save multiples of that cost through the reduction in joint replacements and in-patient admissions.